Current problems and future developments in disease eradication schemes.
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A survey of the abattoirs in 10 selected towne in Nigeria showed that about 41.9 per cent of whole carcasses condemned between 1975 and 1977 were due to tuberculosis and 22.2 per cent to beef cysticercosis. Seventy per cent of organ condemnations, mainly of livers, were due to fascioliasis. Other major causes of organ condemnations were hydatid cysts, tuberculosis and pneumonia of various causes. An estimated 500 tonnes of meat valued at about 1.25 million Naira (US $1.8 million) are condemned each year throughout Nigeria. The use of abattoirs as monitoring stations in national animal disease eradication programmes is highlighted.
The rapidly increasing use of water for agricultural and hydroelectric development in developing countries is causing serious health problems. These can be divided into two categories; the diseases whose transmission depends on water; and the changes in the life style of the population. We review briefly the principal health problems and analyze the principles to be followed in solving them, and the reasons of the success or failure of health programs. Among the topics we consider, are the development versus health, the collaboration of health service personnel with the rest of the personnel participating in water development schemes, the necessity of ensuring a multidisciplinary approach to the solutions of these health problems, the necessity of integration of the public health component within the administrative and budgetary levels and the coordination of public health measures with the development of project from the planning phase through the completion and maintenance phases, the purely medical aspects of the health problems involved appearing as being of secondary importance. Common sense, and the use of simple, cheap methods adapted to the local conditions, and applied focaly, provide better solutions than the sophisticated, more general and expensive approaches. The time and budget accorded for surveys and research, usually excessive, should be limited. It is necessary to adhere to a disciplined use of water. Ambitions and utopian dreams and strategies of disease eradication should, in general, give way to more limited, but accessible objectives, whose attainment would lead to a decrease of the clinical and socioeconomic gravity of the health problems to a "reasonable" level.
Thirty-two patients with limited-stage small cell lung cancer were treated with combined supervoltage radiotherapy and a combination of cyclophosphamide, doxorubicin and vincristine chemotherapy. The goal of obtaining a complete remission, the necessary step which precedes improved survival, was successful in 26 of 27 of completely re-evaluated patients. Fiberoptic bronchoscopy was useful in substantiating complete remission status. Seventeen of the 32 patients remain alive from 8+ to 28+ months (median 16+ months). Ten patients are alive and relapse-free from 12+ to 28+ months (median 19+ months). Transient granulocytopenia (mean nadir 650 cells/mm3) during induction therapy and the associated risk of infection were the most serious toxicities encountered. This therapy produces complete remission on roentgenography and bronchoscopy, symtomatic improvement and improved survival in the majority of patients with limited-stage small cell lung cancer. A portion of these patients may have their disease eradicated.
Eight British adults with tumours histologically and cytochemically identical to African Burkitt's lymphoma are described. In each case there was an acute clinical onset and similar tumour distribution, with involvement of the intra-abdominal organs, bone marrow and central nervous system. Jaw tumours were only present in 3 cases, and were never gross. Four patients presented as acute leukaemia. Combination chemotherapy and cranial irradiation were used to eradicate disease, but complete remissions were obtained in only 3 patients, and survival of over 1 year in only 2. The remainder died with disease present, less than 5 months from diagnosis.
CRISPR-Cas9 gene drives (CCGDs) are powerful tools for genetic control of wild populations, with applications from disease eradication to species conservation. However, Cas9 alone and in a complex with gRNA can cause double-stranded DNA breaks at off-target sites, which could increase the mutational load and lead to unintended loss-of-heterozygosity (LOH) events. These undesired effects raise potential concerns about the long-term evolutionary safety of CCGDs, but the magnitude of these effects is unknown. To measure how the presence of a CCGD or a Cas9 alone in the genome affects the rates of LOH events and de novo mutations, we carried out a mutation accumulation experiment in yeast Saccharomyces cerevisiae. We found no detectable effects on the genome-wide rates of mutations or LOH events. Our power calculations suggest that CCGD or Cas9 affect these rates by less than 30%, which is much less than natural variation for these traits in yeast. A more detailed examination shows that CCGD or Cas9 may alter the lengths and genomic distributions of LOH events, but the statistical support for these effects is weak. Thus, our results demonstrate that CCGDs impose at most a weak additional mutational burden in the yeast model. Although mutagenic effects of gene drives need to be further evaluated in other systems, our results add credence to the proposition that the evolutionary risks posed by well designed gene drives are likely acceptable.
Arrangements for extramural education including "seeing practice" experience in nine European veterinary schools (Bristol, Glasgow, Liverpool, Helsinki, Stockholm, Hannover, Ghent, Toulouse and Vienna) are described. Considerable differences existed between three UK schools, and between them and the Continental schools, where arrangements were usually voluntary. The amount of extramural experience in different types of work was quantified by student questionnaires. An average of 12 weeks' experience in farm practice was gained by 83 per cent of the 339 students, six weeks' small animal work by 48 per cent, four weeks in an abattoir by 43 per cent and other periods in specialised practices, laboratories and veterinary faculties. Practice abroad was experienced by 10 per cent. The total experience of different medical and surgical conditions varied considerably between schools as a result of disease eradication (eg, swine fever in UK), non-occurrence (canine leptospirosis in Sweden and Finland) or the availability of surgical or reproductive material, as well as on other factors.
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A 5-year-old boy living in a small camp in the rural Ivory Coast had a disease resembling smallpox. This occurred 4 years after smallpox had been eradicated from the Ivory Coast and 1.5 years after the last case of smallpox was detected in West and Central Africa. Clinical, serological, and epidemiological evidence indicated this disease was probably monkeypox, a poxvirus of the variola/vaccina subgroup. A serologic survey of poxvirus antibodies in the wild animal population detected neutralizing antibodies in rodents, larger mammals, primates, and birds. The laboratory and ecological characteristics of poxviruses require further elucidation, especially those which have been found in animals near human monkeypox cases.
The importance of hydatid disease in man and domesticated animals in Britain, and particularly in Wales, is reviewed. While the disease occurs throughout Wales the rural population in Powys shows the highest rate as estimated by hospital records and serological findings. The losses due to offal condemnation in sheep and cattle are estimated as at least 250,000. It is suggested that the feasibility of an area eradication scheme for Wales should be investigated; the form which this scheme might take is outlined.
The counterimmunoelectrophorsis test was applied on three Aleutian disease virus-infected mink ranches for the detection of specific Aleutian disease virus antibody. All mink on the ranches were tested during the pelting season and before the breeding season for 4 consecutive years. Aleutian disease has been eliminated from the three commercial mink ranches by culling out all mink that were positive for Aleutian disease virus antibody.
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Cost-benefit analysis is an important in the rational direction of health policy. The results with respect to poliomyelitis are examined in the light of the money spent and the advantages obtained. It is shown that the cost-benefit ratio has been 1 : 12.98, i.e. every lira spent on vaccination has resulted in a direct saving of 12.98 lire with respect to cases prevented and the cost of their treatment and patient rehabilitation. The ratio is, of course, higher if indirect benefits of a social, moral and occupational kind are included. Some observations are offered on the areas to which cost-benefit analysis can be applied and the ground that it covers.
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